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Mustacchi G, Puglisi F, Molino AM, Crivellari D, Ghiotto C, Ferro A, Brunello A, Saracchini S, Turazza M, Cretella E, Iop A, Malagoli M, Stefani M. Observational study on adjuvant trastuzumab in HER2-positive early breast cancer patients. Future Oncol 2015; 11:1493-500. [DOI: 10.2217/fon.15.34] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Aim: This observational study investigates the use of adjuvant trastuzumab (AT) in HER2-positive breast cancer patients in a real-life setting, focusing on relapse and discontinuation rates. Patients & methods: Data on a group of HER2-positive patients collected from 13 oncology centers of northeast Italy were analyzed. Results: In total, 1245 patients were analyzed. 13.1% of patients were excluded from AT because of comorbidities, age, tumor stage, refusal or other reasons; 8.2% of patients who received AT interrupted the therapy, mainly for toxicity. Overall the relapse rate was 10.9% in the AT-treated population versus 22.6% in nontreated patients (follow-up: 37.4 and 62.1 months, respectively). Disease-free survival (DFS) was lower in AT-relapsed patients than in not-relapsed. Statistical analysis showed a correlation between DFS and estrogen receptor status in AT-treated patients. Conclusion: Relapse rates are lower in clinical setting compared to clinical trials. Overall, AT is effective in HER2-positive early-stage breast cancer patients.
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Affiliation(s)
- G Mustacchi
- Medical Oncology, University of Trieste, Via Lucrezio 9, 34134 Trieste, Italy
| | - F Puglisi
- Department of Oncology, AOUI Udine, Italy
| | - AM Molino
- Medical Oncology, AOUI, Verona, Italy
| | - D Crivellari
- Medical Oncology C, CRO, IRCCS, Aviano (PN), Italy
| | - C Ghiotto
- Medical Oncology 2, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - A Ferro
- Medical Oncology, Santa Chiara Hospital, Trento, Italy
| | - A Brunello
- Medical Oncology, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - S Saracchini
- Medical Oncology, S Maria degli Angeli Hospital, Pordenone, Italy
| | - M Turazza
- Medical Oncology, Sacro Cuore Don Calabria Hospital, Negrar (Verona), Italy
| | | | - A Iop
- Medical Oncology, ASS5 FVG, Palmanova (UD), Italy
| | | | - M Stefani
- Medical Oncology, ULSS 10 Veneto, San Dona’ di Piave (VE), Italy
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HER2-positive metastatic breast cancer: a changing scenario. Crit Rev Oncol Hematol 2015; 95:78-87. [PMID: 25748080 DOI: 10.1016/j.critrevonc.2015.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/18/2014] [Accepted: 02/04/2015] [Indexed: 01/31/2023] Open
Abstract
Adjuvant trastuzumab (AT) dramatically improved HER2-positive breast cancer prognosis. Relapsed disease after AT has different patterns and information is available from observational studies. In this Review Chemotherapy regimens combined to anti-HER2 blockade are discussed, focusing in particular the role of anthracyclines, taxanes and capecitabine. The use of trastuzumab beyond progression and the role of other anti-HER2 agents like lapatinib, pertuzumab and T-DM1 are explored, as also dual blockade and in trastuzumab resistant Patients. Metastatic "de novo" HER2 Luminal (co-expression of HER2 and hormone receptors) Patients are eligible for anastrozole and trastuzumab but if pretreated with trastuzumab they are also eligible for lapatinib and letrozole. In any case endocrine treatment plays a complementary role to chemotherapy which remains pivotal. The last topic explored is treatment options for patients with brain metastases where both trastuzumab given concurrent with radiotherapy or lapatinib and capecitabine appear as potentially active.
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